Wiki Need help!! Total knee coding

[twosmek]

So just a brief overview of what the MD did is this.

extremely obese patient presented with an infected TKA. MD in the first encouter removed the prosthesis and placed and antibiotic cement patty with plans to return for 2nd debridement and placement of articulating spacer.

Coded 27488-removal of Total knee prosthesis for that one.

The seconde surgery is what I am a little iffy on how I should code.
MD returned and perfored I&D of the knee joint including debridement of necrotic bone. and placed and biomet stage I articulating antibiotic spacer with no plans to put in a permanent prosthesis as the patient is bedridden. What would you code.
27447-58- (should I put a 52 on there as it is not a prosthesis or 22)
11981-58-51
any help would be helpful and appreciated??

 

[TonyaMichelle]

For the first visit:

27488 reports the removal of a knee prosthesis without concurrent replacement.


For the second visit I would use:

27310 (arthrotomy, knee, with exploration, drainage or removal of foreign body) for example: infection.

11044 (Debridement, bone {includes epidermis, dermis,subcutaneous tissue, muscle and/or fascia, if performed}; first 20sq.cm. or less.

11981 (Insertion, non-biodegradable drug delivery implant)

In the first visit, it was already noted that the physician did not replace the prosthesis.

Hope this helps...

 

[twosmek]

That does make sense. I don't know why I didn't think of that before. Thanks